CORPORATE ACCOUNT OPENING FORM (Incorporated and Non Incorporated)

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Welcome to Our Corporate Account Opening Section. Kindly fill the form appropriately to enable us commence your account opening procedures. Please ensure that all information supplied are accurate and current

TYPE OF ACCOUNT

COMPANY DETAILS

ACCOUNT SERVICES

SIGNATORY DETAILS

ACCOUNT MANDATE

INDEMNITY/DECLARATION

Category of Business *

PartnershipSole ProprietorshipMDA'sSchoolChurchOthers

Kindly tick as appropiate

Account Type *

Corporate Current AccountFixed Deposit Account

Kindly tick as appropiate

COMPANY DETAILS

Company/Business Name *

Certificate of Incorporation/Registration Number *

Date of Incorporation/Registration *

Country of Incorporation/Registration

Nature of Business *

Sector/Industry

Operating Address *

Email Address *

Phone Number 1 *

Registered Address (If different from Operating Address)

Website Url

Phone Number 2

Tax Identification Number

Annual Turnover *

Less than N50MN50M - Less than N500M500M - Less than 5 Billion5 Billion and above

Is your company listed in the Stock Exchange?

YesNo

What Stock Exchange and Symbol

ACCOUNT SERVICES

Card Preference

Verve CardMaster CardVisa CardOthers

Electronic Banking Preference

Internet BankingMobile BankingATMPOSOther Electronic Channels

Transaction Alert Preference

Email Alert (free)SMS Alert (fee Apllies)

Cheque Book Requisition (Fee Applies)

Open ChequeCrossed Cheque50 Leaves100 Leaves

Cheque Confirmation:would you like to pre-confirm your cheques?

YesNo

Check confirmation threshold, if yes please specify the threshold

ACCOUNT SIGNATORY/DIRECTOR 1

Title *

Other Names *

First Name *

Surname *

Mother's Maiden Name *

Date of Birth *

Nationality *

Gender *

MaleFemale

Country of Birth

2nd Nationality

Means of Identification *

ID Number *

ID Issue Date *

ID Expiry Date *

BVN Number *

Occupation *

Status/Job Title

Designation

Residential Address *

Please include Street, Nearest Bus Stop/Landmark, Local Government Area, City/Town and State

Phone Number 1 *

Phone Number 2

Email Address

ACCOUNT SIGNATORY/DIRECTOR 2

Title

Other Names

First Name

Surname

Mother's Maiden Name

Date of Birth

Nationality

Gender

MaleFemale

Country of Birth

2nd Nationality

Means of Identification

ID Number

ID Issue Date

ID Expiry Date

BVN Number

Occupation

Status/Job Title

Occupation

Status/Job Title

Designation

Residential Address

Please include Street, Nearest Bus Stop/Landmark, Local Government Area, City/Town and State

Phone Number 1

Phone Number 2

Email Address

ACCOUNT SIGNATORY/DIRECTOR 3

Title

Other Names

First Name

Surname

Mother's Maiden Name

Date of Birth

Nationality

Gender

MaleFemale

Country of Birth

2nd Nationality

Means of Identification

ID Number

ID Issue Date

ID Expiry Date

BVN Number

Occupation

Status/Job Title

Occupation

Status/Job Title

Designation

Residential Address

Please include Street, Nearest Bus Stop/Landmark, Local Government Area, City/Town and State

Phone Number 1

Phone Number 2

Email Address

ACCOUNT MANDATE 1

Category of Business *

PartnershipSole ProprietorshipMDA'sSchoolChurchOthers

Kindly tick as appropiate

Account Type *

Corporate Current AccountFixed Deposit Account

Kindly tick as appropiate

BVN Number *

Mandate Authorisation

Sole SignatoryEither to SignBoth to Sign

First Name *

Other Names *

Identification Type *

Telephone Number

Surname *

Class of Signatory

Identification No *

Date

Recent Passport Photograph *

Browse

Upload your recent passport photograph

ACCOUNT MANDATE 2

Category of Business

PartnershipSole ProprietorshipMDA'sSchoolChurchOthers

Kindly tick as appropiate

Account Type

Corporate Current AccountFixed Deposit Account

Kindly tick as appropiate

BVN Number

Mandate Authorisation

Sole SignatoryEither to SignBoth to Sign

First Name

Other Names

Identification Type

Telephone Number

Surname

Class of Signatory

Identification No

Date

Recent Passport Photograph

Browse

Upload your recent passport photograph

ACCOUNT MANDATE 3

Category of Business

PartnershipSole ProprietorshipMDA'sSchoolChurchOthers

Kindly tick as appropiate

Account Type

Corporate Current AccountFixed Deposit Account

Kindly tick as appropiate

BVN Number

Mandate Authorisation

Sole SignatoryEither to SignBoth to Sign

First Name

Other Names

Identification Type

Telephone Number

Surname

Class of Signatory

Identification No

Date

Recent Passport Photograph

Browse

Upload your recent passport photograph

Mandate Authorisation

Sole SignatoryEither to SignBoth to Sign

Date

Authorisation/Indeminity for Email Messages

Jubilee Life Mortgage Bank Plc with registered office at Plot 73 Adeola Hopewell, Victoria Island Lagos (hereinafter called "The Bank"), is hereby authorised to honour instruction for payment in relations to our account

Account Name

with the bank coming from

Email Address

being the email address bearing or purporting to bear our

Account Name

2. The said email instruction will be preceded by the code/password

Password

3. and are hereby authorised by the Company to send email instructions to the Bank

4. We undertake to forward the original copy of any given email instruction made in accordance with the account mandate to the bank on or before

number of days

days from the date of such instruction

5. We understand that emails are an insecure transmission medium and are subject to call back procedures and hereby indemnify you against any loss, liability or damage as well as cost, charges and expenses which may suffer or incur however arising by reason of your honouring such items be it erroneous, fraudulent or otherwise drawn as aforesaid.

Date

DECLARATION

I/We hereby apply for the opening of account(s) with Jubilee Life Mortgage Bank Plc. I/We understand that the information given herein and the documents supplied are the basis for opening account(s) and therefore warrant that such information is correct.